Preventive Gynecological Examinations
The basic gynecological examination starts with inserting the speculum (dioptra) into the vagina. The goal is to get a clear view of the cervix and vaginal walls. After different swabs can be performed, e.g., Pap smear, swab cultures of pathogenic bacteria, HPV, STI, etc. When the speculum is removed, the gynecologist examines the vaginal opening and the entire external genitalia. This is followed by the bimanual examination (pelvic examination). With one or two fingers inserted into the vagina, the gynecologist palpates the internal reproductive organs while applying pressure to the abdominal wall with the other hand if needed. With this, possible pain is assessed, and the size of the organs in the lesser pelvis is roughly estimated.
The Pap smear (named after its inventor Georgios Papanikolaou) is a cervical cancer screening method. It assesses the sample for cellular abnormalities that occur in precancerous and cancerous lesions, especially those caused by HPV infection. The gynecologist swabs the cervix and the external cervical canal opening with a cervical spatula or a brush. This collects the cells situated in that area. The cells are smeared on a microscope slide and then sent to a cytology laboratory where a cytologist-pathologist assesses the cells. The results are known in one to three weeks.
Transvaginal ultrasound has in the last ten years become an essential part of a comprehensive gynecological examination. It has become clear that bimanual examination alone does not suffice for examining the ovarian structures and structures in the uterus, including a pregnancy.
The transducer is inserted into the vagina, getting as close as possible to the internal reproductive organs, allowing for a precise examination of the whole uterus and the ovaries. It is indispensable for early pregnancy examinations.
Only a technologically sound apparatus in the hands of an experienced doctor can give an accurate and reliable result.